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Paroxysmal Tonic Upgaze Mimicking Infantile Seizure

Akyol, F. 2023Other/Unknown

Akyol, F., Ağ, Z. N., & Kırık, S. (2023). Paroxysmal Tonic Upgaze Mimicking Infantile Seizure. Ankara Med J, 23(1), 132-136. https://doi.org/10.5505/amj.2023.56563.

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Abstract

Non-epileptic paroxysmal events are very important in daily clinical practice.Paroxysmal tonic upgaze is a rare neuro-ophthalmologic non-epileptic paroxysmal condition characterized by episodes of continuous conjugated upward deviation of the eyes and normal horizontal gaze.Its pathogenesis is unknown, and its etiology is heterogeneous.The prognosis is often benign, but it's often confused with epilepsy.We present a case of "paroxysmal tonic upgaze" with a benign clinical course and spontaneous remission.

Case Details

Disease Location

Brain

Personal Characteristics

6-month-old female, history of phototherapy due to jaundice in the neonatal period, her cousin had a diagnosis of epilepsy.

Clinical Characteristics

Recurrent attacks accompanied by a sudden upward gaze in the eyes and neck flexion, which started two weeks after treatment for the diagnosis of bronchiolitis due to cough and fever complaints that started 20 days ago. Suspicion of epilepsy, as the attacks continued increasingly during the day. There was no change in consciousness during the attacks, and it was described that these attacks disappeared during sleep.

Remission Characteristics

During the follow-up, the number and duration of the attacks decreased and decreased significantly after the seventh day. Attacks were rarely described in the first month of follow-up.

Treatment & Mechanisms

Proposed Remission Mechanisms

Transient condition

Non-Clinical Treatment

None reported